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An article in the NEJM and accompanying editorial suggests that bystander cardiac compression is as good as full CPR, seems a good study. Your thoughts? Matthew > http://www.nejm.org/content/2000/0342/0021/1546.asp > > > Cardiopulmonary Resuscitation by Chest Compression Alone or with > > Mouth-To-Mouth Ventilation > > > > Alfred Hallstrom, Leonard Cobb, Elise Johnson, Michael Copass > > > > Background. Despite extensive training of citizens of Seattle in > > cardiopulmonary resuscitation (CPR), bystanders do not perform CPR in > > almost half of witnessed cardiac arrests. Instructions in chest > > compression plus mouth-to-mouth ventilation given by dispatchers over > > the telephone can require 2.4 minutes. In experimental studies, chest > > compression alone is associated with survival rates similar to those with > > chest compression plus mouth-to-mouth ventilation. We conducted a > > randomized study to compare CPR by chest compression alone with > > CPR by chest compression plus mouth-to-mouth ventilation. > > Methods. The setting of the trial was an urban, fire-department-based, > > emergency-medical-care system with central dispatching. In a > > randomized manner, telephone dispatchers gave bystanders at the scene > > of apparent cardiac arrest instructions in either chest compression alone > > or chest compression plus mouth-to-mouth ventilation. The primary end > > point was survival to hospital discharge. > > Results. Data were analyzed for 241 patients randomly assigned to > > receive chest compression alone and 279 assigned to chest compression > > plus mouth-to-mouth ventilation. Complete instructions were delivered > > in 62 percent of episodes for the group receiving chest compression > > plus mouth-to-mouth ventilation and 81 percent of episodes for the > > group receiving chest compression alone (P=0.005). Instructions for > > compression required 1.4 minutes less to complete than instructions for > > compression plus mouth-to-mouth ventilation. Survival to hospital > > discharge was better among patients assigned to chest compression > > alone than among those assigned to chest compression plus mouth-to- > > mouth ventilation (14.6 percent vs. 10.4 percent), but the difference was > > not statistically significant (P=0.18). > > Conclusions. The outcome after CPR with chest compression alone is > > similar to that after chest compression with mouth-to-mouth ventilation, > > and chest compression alone may be the preferred approach for > > bystanders inexperienced in CPR. (N Engl J Med 2000;342:1546-53.) > > > > > > Dr Matthew Cooke > > Senior Lecturer in Emergency Care ( www.emerg-uk.com ) > > Emergency Medicine Research Group > > Centre for Primary Health Care Studies, Univ of Warwick, CV4 7AL > > Tel 07074 782377 Fax 0870 063 6506 > > > > > %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%